Case presentation A five-week-old female twin presented to the emergency department with complaints of difficulty in feeding with decreased duration, increased lethargy, and pallor. She is a diamniotic dichorionic twin born via C-section at 36 5/7 weeks. The mother’s history includes conception via in-vitro fertilization and febrile illness while pregnant with a maculopapular rash.
However, her twin brother was asymptomatic. Initial examination Febrile: 100°F Pale Tachycardia Palpable spleen Clinical manifestations Anemia Pale body Fatigue Decreased arousal Difficulty in feeding Lethargy Laboratory investigations performed Complete blood count Blood cultures Urinalysis Urine culture Lumbar puncture Smear test Polymerase chain reaction (PCR) IgG, IgM detection Significant lab results Hemoglobin levels: 3.4 gm/dL Hematocrit: 9.4% Leucocytosis: 16,000k/mm3 Platelets: 104k/mm3…
